Introduction: Multiple sclerosis (MS) is a complex disease with a heterogeneous and unpredictable clinical course. Mobility impairment after progressive paralyses and muscle tone spasticity is common.

Areas covered: The prevalence, assessment, and pharmacological management of gait impairment and spasticity in MS and their effects on health-related quality of life (HRQoL) are discussed. The roles of oral and intrathecal baclofen and of delta-9-tetrahydrocannabinol/cannabidiol (THC:CBD) oromucosal spray in treating MS spasticity-related gait impairment are reviewed.

Expert commentary: Mobility impairment and spasticity are experienced by approximately 90% and 80% of MS patients, respectively, during the disease course. Prevalence and severity of gait impairment and spasticity increase as disease progresses. The symptoms are related and both impact negatively on HRQoL. Oral baclofen and tizanidine are generally used for first-line treatment of MS spasticity but are ineffective in approximately 40% of cases. Second-line therapy includes add-on THC:CBD spray for patients with resistant MS spasticity. Results of studies evaluating baclofen for treating MS spasticity gait impairment are equivocal.

I agree, very interesting study and I want to understand more how much is needed to help and what amt of spasticity drugs is it being added on to as therapy.

I did a quick google search and found this info on a spray (not avail in US).
“Sativex® is an oromucosal spray of a formulated extract of the cannabis sativa plant that contains the principal cannabinoids delta-9-tetrahydrocannibinol (THC) and cannabidiol (CBD) in a 1:1 ratio as well as specific minor cannabinoids and other non-cannabinoid components. We developed Sativex® to be administered as an oromucosal spray, whereby the active ingredients are absorbed in the lining of the mouth, either under the tongue or inside the cheek.l”.
The description doesn’t give enough info to compare to capsules. I don’t know if patent may specify mgs or if full clinical trials documentation would specify more. But I wonder if the method of absorbstion vs oral allows for smaller doses. .? Regardless, if US lawmakers could understand how awful spasticity is and how current pharmaceuticals aren’t helpful to many msers maybe these kind of studies will eventually lead to more relief from this awful symptom. Let,s hope.

I see there is a session on the first day of ECTRIMS next week, dealing with the use of cannabinoids and spasticity. That could be interesting, hope the general public can at least get to the abstracts.

By the way, in case you weren't aware, the US Government (the NIH) holds the patents on many of the non psychoactive cannabinoid compounds. I think those patents are scheduled to expire in just a couple of years. That could set up a free for all WRT new refined drugs from various cannabinoid compounds so stay tuned. If any of the hundreds of cannabinoid compounds can in fact relieve some MS symptoms, specifically pain and spasticity, they may be coming in an FDA approved version soon!

I have been having tremendous relief from this spray. Much less spasticity and stiffness. I take a spray periodically throughout the day and night. Finding the right dose is highly individualistic and is a trial and error of start low and go slow.